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Using an Economic Evaluation to Compare the Effectiveness of Healthcare Systems in Europe
Blekinge Institute of Technology, Faculty of Engineering, Department of Industrial Economics.ORCID iD: 0000-0003-4620-7472
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Background Worldwide, healthcare systems are struggling with rising health expenditures and inefficient healthcare systems. Moreover, an aging population, longer lifespans, and infectious diseases put more pressure on healthcare systems. Healthcare's performance, efficiency, and effectiveness need to be evaluated to prevent a further rise in health expenditure. In Europe, healthcare systems can be broadly categorized into two models: the Beveridge model and the Bismarck model. These two healthcare systems' performance, efficiency, and effectiveness have been discussed over the past decade. Many researchers have tried to determine which healthcare system performs better and more effectively. However, a clear conclusion has yet to be reached.

Methods This research compared the performance and effectiveness of 27 European countries using Beveridge-type and Bismarck-type healthcare systems from 2000 to 2020. This research used life expectancy at birth as a health outcome indicator to represent population health and evaluate the performance of two healthcare systems. The health expenditure per capita PPP was used as medical spending. A Welch's t-test was first employed to measure the performance of the two healthcare systems. This study then applied economic evaluation to compare the effectiveness of the two healthcare systems.

Results Welch’s t-test results demonstrated that life expectancy at birth in countries using the Beveridge-type healthcare system was statistically significantly higher than in countries using the Bismarck-type healthcare system. The effectiveness ratio of the period from 2000 to 2020 showed that the Beveridge-type healthcare system has a higher value of medical spending than the Bismarck-type healthcare system.

Conclusions The results revealed that the Beveridge-type healthcare system performed better and was more cost-effective than the Bismarck-type healthcare system. Policymakers should be careful when choosing or shifting a healthcare model for their countries.

Keywords [en]
value of medical spending, economic evaluation, cost-effectiveness ratio, cost per year of life gained, life expectancy at birth
National Category
Economics
Research subject
Industrial Economics a nd Managemen
Identifiers
URN: urn:nbn:se:bth-26117OAI: oai:DiVA.org:bth-26117DiVA, id: diva2:1852606
Available from: 2024-04-18 Created: 2024-04-18 Last updated: 2024-04-25Bibliographically approved
In thesis
1. Enhancing the Performance and Efficiency of Healthcare Systems Using Industrial Economic Principles and Statistical Techniques
Open this publication in new window or tab >>Enhancing the Performance and Efficiency of Healthcare Systems Using Industrial Economic Principles and Statistical Techniques
2024 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Optimizing healthcare systems has become more crucial in recent years due to escalating healthcare demands and economic constraints. This dissertation employed industrial economic principles and advanced statistical methods to analyze the performance and efficiency of healthcare systems in Europe. The study provided a detailed analysis of how healthcare systems can enhance service delivery and maintain cost-effectiveness by integrating industrial economic theories with empirical data. The dissertation was organized into a series of analyses, each focusing on different aspects of healthcare system performance, resource allocation, operational efficiency, and forecasting future health demands, as well as evaluating the accuracy of these forecasting models. Statistical techniques such as time series and multilevel regression analyses were used to examine the interplay between healthcare resources, healthcare systems, and health outcomes across European nations. The two main healthcare models in Europe, the Beveridge and Bismarck models, were compared in terms of performance, efficiency, and resource allocation. The main findings revealed that effective resource allocation and efficient management practices can significantly enhance the performance of healthcare systems. The study indicated that a healthcare system's efficiency depends on its ability to adjust resource allocation to changes in demographic and economic conditions. Additionally, this dissertation forecasted future demands for healthcare services, social security benefits, and pensions by incorporating macro-level determinants such as economic growth, unemployment rates, and population density into the forecasting models. The accuracy of these models provided valuable insights for policymakers to effectively plan for future healthcare, social security, and pension needs. Moreover, this dissertation employed an economic evaluation to compare the cost-effectiveness of Beveridge-type and Bismarck-type healthcare systems over the past twenty years. An effectiveness ratio was applied to measure the relationship between inputs (medical spending) and outputs (health outcomes). These effectiveness ratios demonstrated which healthcare system yields better health outcomes for each dollar spent. Furthermore, the findings indicated that the efficiency of healthcare systems varies from country to country, highlighting the challenges of adopting a universal approach to healthcare policy. This dissertation contributes to the academic field by demonstrating how industrial economic principles can be applied to improve the performance and efficiency of healthcare systems. It offered a framework for evaluating healthcare performance and efficiency, which can inform future reforms to achieve sustainable, high-quality healthcare services. This study promotes a dynamic approach to healthcare planning that adapts to technological advancements and demographic changes to enhance population health. 

Place, publisher, year, edition, pages
Karlskrona: Blekinge Tekniska Högskola, 2024. p. 370
Series
Blekinge Institute of Technology Doctoral Dissertation Series, ISSN 1653-2090 ; 10
Keywords
Healthcare system efficiency, industrial economics, performance measurement, healthcare resource allocation, healthcare model comparison, forecasting healthcare demand
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
Industrial Economics a nd Managemen
Identifiers
urn:nbn:se:bth-26122 (URN)978-91-7295-483-0 (ISBN)
Public defence
2024-06-13, J1630, Blekinge Institute of Technology, 371 79 Karlskrona, Karlskrona, 13:00 (English)
Opponent
Supervisors
Available from: 2024-04-19 Created: 2024-04-18 Last updated: 2024-05-23Bibliographically approved

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